生活方式改变加口腔护理（LCDC）方案对改善 2 型糖尿病老年患者血糖和牙周状况的效果。
Effectiveness of lifestyle change plus dental care (LCDC) program on improving glycemic and periodontal status in the elderly with type 2 diabetes.
机构信息
Health center 54, Bangkok, Thailand.
出版信息
BMC Oral Health. 2014 Jun 16;14:72. doi: 10.1186/1472-6831-14-72.
BACKGROUND
Currently, there is an increased prevalence of diabetes mellitus among the elderly. To minimize adverse effects on glycemic control, prevention and management of general and oral complications in diabetic patients is essential. The purpose of the present study is to assess the effectiveness of a Lifestyle Change plus Dental Care (LCDC) program to improve glycemic and periodontal status in the elderly with type 2 diabetes.
METHODS
A quasi-experimental study was conducted in Health Centers 54 (intervention) and 59 (control) from October 2013 to January 2014. 66 diabetic patients per health center were included. At baseline, the intervention group attended a 20 minute lifestyle and oral health education program, individual lifestyle counseling using motivational interviewing (MI), application of self regulation manual, and individual oral hygiene instruction. The intervention group received booster education every visit by viewing a 15 minute educational video. The control group received a routine program. Participants were assessed at baseline and 3 month follow up for glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), body mass index (BMI), periodontal status, knowledge, attitude and practice of oral health and diabetes mellitus. Data were analyzed by using descriptive statistic, Chi-square test, Fisher's exact test, t-test, and multiple linear regression.
RESULTS
After the 3 month follow up, a multiple linear regression analysis showed that the intervention group was significantly negatively correlated in both glycemic and periodontal status. Participants in the intervention group had significantly lower glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), plaque index score, gingival index score, pocket depth, clinical attachment level (CAL), and percentage of bleeding on probing (BOP) when compared to the control group.
CONCLUSIONS
The combination of lifestyle change and dental care in one program improved both glycemic and periodontal status in the elderly with type 2 diabetes.
TRIAL REGISTRATION
ClinicalTrials.in.th: TCTR20140602001.
背景
目前，老年人群中糖尿病的患病率有所增加。为了将血糖控制的不良影响降到最低，对糖尿病患者的一般和口腔并发症进行预防和管理至关重要。本研究旨在评估生活方式改变加口腔护理（LCDC）方案对改善 2 型糖尿病老年患者血糖和牙周状况的效果。
方法
2013 年 10 月至 2014 年 1 月在卫生中心 54（干预组）和 59（对照组）进行了一项准实验研究。每个卫生中心纳入 66 例糖尿病患者。在基线时，干预组参加了 20 分钟的生活方式和口腔健康教育课程、使用动机访谈（MI）的个人生活方式咨询、自我调节手册的应用以及个人口腔卫生指导。干预组每次就诊时通过观看 15 分钟的教育视频接受强化教育。对照组接受常规方案。在基线和 3 个月随访时评估参与者的糖化血红蛋白（HbA1c）、空腹血糖（FPG）、体重指数（BMI）、牙周状况、口腔健康和糖尿病知识、态度和实践。采用描述性统计、卡方检验、Fisher 确切检验、t 检验和多元线性回归分析数据。
结果
在 3 个月随访后，多元线性回归分析显示，干预组的血糖和牙周状况均呈显著负相关。与对照组相比，干预组的糖化血红蛋白（HbA1c）、空腹血糖（FPG）、菌斑指数评分、牙龈指数评分、牙周袋深度、临床附着水平（CAL）和探诊出血百分比（BOP）显著降低。
结论
将生活方式改变与口腔护理相结合纳入一个方案可改善 2 型糖尿病老年患者的血糖和牙周状况。
试验注册
ClinicalTrials.in.th：TCTR20140602001。
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